Abstract
Deep infection is one of the most serious complications after total hip replacement (THR). The aim of this study is to evaluate the efficacy of one stage revision THR for deep infection with a long-term follow-up.
One stage revision THR for deep infection was carried out in 285 joints on 274 patients by a single surgeon (BMW) between 1974 and 2001. All infected hip replacements are primarily treated with one stage revision THR at the authors’ unit unless bone stock is extremely poor. This study included a review of 162 revisions in 154 for which a minimum follow-up of five years had been done. The mean duration of follow-up was 12.3 years.
Trochanteric osteotomy was done for extensive resection of infected tissue and removal of cement. Both cups and stems were revised with bone cement. Antibiotic-loaded cement was used in 152 cases (93.8%). Further antibiotics were commenced systemically for 6–12 weeks postoperatively.
Failure of infection control was defined as a) reoperation for recurrent infection or b) clinically persistent infection. Infection control. One hundred and thirty eight hips (85.2%) were free of infection at the time of the latest follow-up. 1) No sinus group (N=110): Success rate was 82.7 %. 2) Sinus group (N=52): Success rate was 90.4 %.
This study presents the longest follow-up with a large number of cases in revision THR for deep infection. At least, history of discharging sinus was not considered as a contraindication. The results suggested that one stage revision was an effective treatment for deep infection of hip replacement in the long term.
The abstracts were prepared by Mr Richard Buxton. Correspondence should be addressed to him at Bankton Cottage, 21 Bankton Park, Kingskettle, Cupar, Fife KY15 7PY, United Kingdom
